Cover
Title Page
List of Contributors
Foreword
Section I: Clinical Overview
1. 1 Risk Factors for Venous Thromboembolism
  1. Introduction
  2. Previous VTE
  3. Surgery
  4. Hospitalised Medical Patients
  5. Cancer Associated Thrombosis (CAT)
  6. Pregnancy
  7. Combined Oral Contraceptive Use
  8. Family History of VTE and Thrombophilia
  9. Obesity
  10. Travel
  11. Substance Abuse
  12. Conclusion
  13. Further Reading
2. 2 Management of Venous Thrombosis in the Lower Limbs
  1. Introduction
  2. Diagnosis
  3. Treatment
  4. Further Reading
3. 3 Clinical Presentation of Acute Pulmonary Embolism
  1. Introduction
  2. Symptoms of Acute PE
  3. Clinical Signs of Acute PE
  4. Differential Diagnosis
  5. Clinical Presentation in Specific Patient Subgroups
  6. Clinical Presentation and Associated Prognosis
  7. Summary
  8. Further Reading
Section II: Diagnosis
1. 4 Clinical Prediction Scores
  1. Pulmonary Embolism
  2. Deep Vein Thrombosis
  3. Potential Pitfalls
  4. Key Reading
2. 5 Laboratory Aspects in Diagnosis and Management of Venous Thromboembolism
  1. Introduction
  2. Laboratory Diagnostics of Venous Thromboembolism
  3. Laboratory Prediction of Recurrent Venous Thromboembolism
  4. Laboratory Monitoring of Anticoagulant Therapy
  5. References
3. 6 Thrombophilia Testing
  1. Introduction
  2. Inherited Risk Factors
  3. Acquired Risk Factors
  4. Mixed Risk Factors
  5. Indications for Thrombophilia Testing
  6. Further Reading
4. 7 Radiological Diagnosis of Pulmonary Embolism
  1. Introduction
  2. Ventilation‐perfusion Scanning (V/Q Scintigraphy)
  3. Spiral Computed Tomography Pulmonary Angiography (CTPA)
  4. The Issue of Subsegmental PE
  5. Haemodynamic Assessment of Patients with PE
  6. Latest Trends
  7. Cost‐effectiveness
  8. Summary
  9. References
5. 8 The Antiphospholipid Syndrome
  1. Antiphospholipid Antibodies: Epidemiology and Antigenic Specificities
  2. Thrombosis
  3. Management of APS
  4. Management of Pregnancy
  5. Management of Catastrophic APS
  6. Review Articles
  7. Guidelines
  8. References
Section III: Treatment
1. 9 Inpatient or Outpatient Anticoagulation
  1. Introduction
  2. Deep Vein Thrombosis
  3. Pulmonary Embolism
  4. Sub‐segmental Pulmonary Embolism
  5. The Importance of a VTE Clinic
  6. Cost‐effectiveness
  7. Summary
  8. Further Reading
2. 10 An Anticoagulant Service in Practice
  1. History
  2. Current Organisation
  3. Referral Process
  4. Induction Appointments
  5. Hospital Discharge Patients
  6. Anticoagulant Clinic Structure
  7. Self‐testing Patients
  8. Direct Oral Anticoagulants (DOACs)
  9. The Future of GCAS
  10. Further Reading
3. 11 Point of Care Testing
  1. International Normalised Ratio (INR)
  2. Quality Control
  3. Comparison with Laboratory Results
  4. Limitations of POC devices
  5. POC D‐dimer tests
  6. Key Learning for POC INR Testing
  7. Further Reading
4. 12 Direct Oral Anticoagulants in the Prevention and Management of Venous Thromboembolism
  1. DOACs in treatment and prevention of Venous Thromboembolism: Introduction
  2. Oral Direct Thrombin Inhibitors
  3. Oral Xa Inhibitors
  4. Systematic reviews and meta‐analyses of DOACs
  5. Practical Issues for DOAC Usage
  6. DOAC use in Specific Patient Subgroups
  7. Further Reading
5. 13 The Role of Thrombolysis in the Management of Venous Thromboembolism
  1. Introduction
  2. Rationale Behind CDT for Acute DVT
  3. Pre‐procedural Evaluation and Indications
  4. Contraindications
  5. Technical Aspects of CDT
  6. CDT Pros and Cons
  7. Outcomes for CDT in DVT
  8. Thrombolysis in Pulmonary Embolism
  9. Upper Extremity DVT
  10. Further Reading
  11. References
6. 14 Inferior Vena Cava Filters in the Management of Venous Thromboembolism
  1. Introduction
  2. Evidence for IVCFs
  3. Complications of IVCFs
  4. IVCF Retrieval
  5. IVCFs and Anticoagulation
  6. Specific Indications for IVCF Placement
  7. IVCF for Primary PE Prophylaxis
  8. Conclusion
  9. Further Reading
  10. Disclosures
  11. References
Section IV: Special Situations
1. 15 VTE in Pregnancy
  1. Introduction
  2. Incidence
  3. Normal Physiological Changes of Pregnancy
  4. Risk Factors
  5. Thrombophilias
  6. VTE Prophylaxis in Pregnancy
  7. Diagnosis of VTE in pregnancy
  8. Management
  9. IVC Filters
  10. VTE in Unusual Sites
  11. Thrombophilia Screening
  12. Massive PE/thrombolysis
  13. Thrombolysis for PE in Pregnancy
  14. Post‐thrombotic Syndrome
  15. Follow‐up
  16. Further Reading
2. 16 Paediatric Venous Thromboembolism
  1. Incidence
  2. Paediatric Pathophysiology
  3. Risk Factors
  4. Clinical Manifestations
  5. Diagnosis
  6. Treatment
  7. Treatment Recommendations
  8. Complications
  9. Post‐thrombotic Syndrome (PTS)
  10. Follow‐up
  11. Further Reading
3. 17 Cancer‐associated Thrombosis
  1. Introduction
  2. Pathophysiology of Cancer‐associated Thrombosis
  3. The Psychological Impact of CAT
  4. Diagnosis of CAT
  5. Challenges in the Management of CAT
  6. Initial Treatment
  7. Long‐term Anticoagulation
  8. Challenging Cases
  9. Use of Inferior Vena Cava Filters
  10. Thromboprophylaxis in Hospitalised Cancer Patients
  11. Thromboprophylaxis in Ambulant Cancer Patients Receiving Chemotherapy
  12. Conclusion
  13. Further Reading
4. 18 Venous Thromboembolism Management in Obese Patients
  1. Challenges of VTE Diagnosis
  2. Treatment of VTE
  3. Drugs Where Recognised Therapeutic Drug Monitoring Overcomes the Challenges of any Changes That Obesity May Have on Drug Pharmacokinetic Profiles
  4. Direct Oral Anticoagulants (DOACs)
  5. Further Reading
5. 19 Venous Thromboembolism in Intensive Care
  1. Introduction
  2. Incidence
  3. Diagnosis
  4. Thromboprophylaxis or Not?
  5. Mechanical Thromboprophylaxis
  6. Treatment of Venous Thromboembolism in the Critically Ill
  7. Conclusion
  8. Further Reading
6. 20 Venous Thromboembolism; a Primary Care Perspective
  1. Introduction
  2. Prevention
  3. References
Section V: Unusual Site Thrombosis
1. 21 Cerebral Venous Thrombosis
  1. Aetiology
  2. Pathophysiology
  3. Clinical Presentation
  4. Diagnosis
  5. Treatment
  6. Secondary Prevention in Patients at Risk
  7. Prognosis
  8. Suggested Further Reading
  9. Financial Disclosure
  10. References
2. 22 Upper Extremity Thrombosis
  1. Overview
  2. Background and Classification
  3. Epidemiology and Risk Factors
  4. Prevention
  5. Diagnosis
  6. Approach to the Diagnosis of Suspected UEDVT
  7. Interventional and Endovascular Therapies
  8. Surgical Treatment
  9. Management of CVC/PICC Devices with UEDVT
  10. Prognosis and Complications
  11. References
3. 23 Management of Intra‐abdominal Thrombosis
  1. Splanchnic Vein Thrombosis
  2. Renal Vein Thrombosis
  3. Ovarian Vein Thrombosis
  4. Further Reading
  5. References
4. 24 Thrombosis in the Retinal Circulation
  1. Introduction
  2. Basic Eye Anatomy
  3. Retinal Vein Occlusion
  4. Retinal Artery Occlusion
  5. Conclusions
  6. Further Reading
  7. Conflicts of Interest/disclosures
  8. References
Section VI: Long‐term Sequelae of VTE
1. 25 Post‐thrombotic Syndrome
  1. Introduction
  2. Pathophysiology
  3. Signs and Symptoms
  4. Risk Factors for Developing PTS
  5. Quality of Life
  6. Scoring Systems
  7. Investigations
  8. Treatment
  9. Prevention Strategies
  10. Further Reading
2. 26 Chronic Thromboembolic Pulmonary Hypertension
  1. Introduction
  2. Epidemiology
  3. Pathophysiology
  4. Clinical Presentation and Patient Evaluation
  5. Treatment
  6. Summary
  7. Further Reading
  8. Bibliography
3. 27 Predicting Recurrent VTE
  1. Factors Influencing Risk of Recurrent VTE
  2. Clinical Prediction Rules for Recurrent VTE
  3. Conclusions
  4. Further Reading
Section VII: Controversies
1. 28 Cancer Screening in Unprovoked Venous Thromboembolism
  1. Further Reading
2. 29 Sub‐segmental and Incidental PE – to Treat or Not?
  1. Introduction
  2. Definitions
  3. Who Gets Incidental/Subsegmental PE?
  4. The Issue of Sub‐segmental PE
  5. Management Approach to Incidental/Sub‐segmental PE
  6. Conclusion
  7. Further Reading
3. 30 Management of Distal Vein Thrombosis
  1. Diagnosis of Distal Deep‐vein Thrombosis
  2. Treatment of Isolated Distal Deep‐vein Thrombosis
  3. References
Section VIII: Prevention
1. 31 A Summary of the Evidence for VTE Prevention, with a Focus on the Controversies
  1. Introduction
  2. Hospitalised Patients
  3. Further Reading
2. 32 VTE Prevention: Real World Practice
  1. The Strategy
  2. Risk Assessment
  3. Appropriate Thromboprophylaxis (TP)
  4. Further Reading
3. 33 VTE Root Cause Analysis – How To Do It
  1. Background
  2. RCA Goes Political; the English Experience
  3. Aims
  4. References
Index
End User License Agreement

List of Tables

Chapter 01
1. Table 1.1 Risk factors for venous thromboembolic disease.
2. Table 1.2 Surgical risk factors for VTE.
3. Table 1.3 Medical conditions with increased risk of VTE.
4. Table 1.4 Risk factors for cancer‐associated VTE.
5. Table 1.5 Pregnancy and risk factors for VTE.
Chapter 03
1. Table 3.1 Prevalence of clinical characteristics in patients with suspected PE.
2. Table 3.2 Differential diagnosis of PE according to the key presenting symptom.
Chapter 04
1. Table 4.1 PERC score.
2. Table 4.2 Wells score for pulmonary embolism.
3. Table 4.3 Wells score for deep vein thrombosis.
4. Table 4.4 Oudega rule.
Chapter 05
1. Table 5.1 Wells’ score for the diagnosis of venous thromboembolism (Wells et al., 1997, 2003).
2. Table 5.2 Characteristics of current anticoagulant drugs and their laboratory monitoring.
Chapter 06
1. Table 6.1 Inherited, acquired and mixed coagulation‐related risk factors for thrombosis.
2. Table 6.2 Prevalence of thrombophilia abnormalities and relative risk of thrombosis.
3. Table 6.3 Current indications for which thrombophilia testing can be considered.
Chapter 07
1. Table 7.1 Recommendations for the use of CTPA for suspected PE.
Chapter 08
1. Table 8.1 Criteria for diagnosis of APS (Miyakis et al., 2006).
Chapter 11
1. Table 11.1 Point of care devices available and their characteristics.
Chapter 12
1. Table 12.1 Current approved indications for DOACs from FDA, EMA and Health Canada.
2. Table 12.2 Specific laboratory assays that can be used to more accurately measure drug levels.
Chapter 13
1. Table 13.1 Extremity signs and symptoms of post‐thrombotic syndrome.
2. Table 13.2 Signs and symptoms of Phlegmasia Cerulea Dolens.
3. Table 13.3 Contraindications to catheter‐directed thrombolysis.
Chapter 14
1. Table 14.1 Professional medical society practice‐based guidelines for IVCF indications.
2. Table 14.2 Summary of randomised controlled trials of IVCFs.
Chapter 15
1. Table 15.1 Risk factors for venous thromboembolism in pregnancy and the puerperium (from RCOG Green‐top Guideline No. 37a).
2. Table 15.2 Prevalence and pregnancy risk of VTE with different heritable thrombophilias.
3. Table 15.3 Suggested LMWH doses for antenatal and postnatal VTE prophylaxis.
4. Table 15.4 Estimated radiation doses associated with investigations for VTE.
5. Table 15.5a Therapeutic dose (treatment dose) of enoxaparin.
6. Table 15.5b Therapeutic dose (treatment dose) of tinzaparin.
Chapter 16
1. Table 16.1 A list of common paediatric risk factors for thrombosis.
Chapter 17
1. Table 17.1 Dosing schedules of different LMWHs in treatment and secondary prevention of CAT.
2. Table 17.2 Summary of ISTH SCC haemostasis and malignancy guidance for challenging cases.
3. Table 17.3 Khorana score for risk of developing VTE during chemotherapy.
Chapter 18
1. Table 18.1 Summary of key points for the treatment of VTE with anticoagulant therapy.
2. Table 18.2 The pharmacokinetic profiles of the newer anticoagulant agents compared to enoxaparin.
Chapter 22
1. Table 22.1 Risk factors for venous access‐associated upper extremity deep vein thrombosis (Joffe and Goldhaber, 2002; van Rooden et al., 2005; Hull et al., 1981).
Chapter 23
1. Table 23.1 Risk factors for splanchnic vein thrombosis.
2. Table 23.2 Risk factors for renal and ovarian vein thrombosis.
Chapter 24
1. Table 24.1 Retinal vein occlusion risk factors and associations.
2. Table 24.2 Retinal artery occlusion risk factors and associations.
Chapter 25
1. Table 25.1 Villalta score.
2. Table 25.2 CEAP classification – patients are assigned a value for each category C, E, A and P. For example, a typical PTS patient would score C_4BE_SA_DP_O.
3. Table 25.3 Venous clinical severity score.
Chapter 27
1. Table 27.1 Risk factors for recurrent VTE following a first unprovoked VTE.
2. Table 27.2 Clinical prediction rules for recurrent VTE following unprovoked first VTE.
Chapter 28
1. Table 28.1 Summary of key trials. See text for details.
Chapter 30
1. Table 30.1 Performance of diagnostic test in patients with suspected distal DVT.
2. Table 30.2 Major and minor risk factors for IDDVT extension or recurrence.

List of Illustrations

Chapter 01
1. Figure 1.1 VTE risk increases with age. Taken from UK VERITY (Venous Thromboembolism registry).
2. Figure 1.2 Risk factors for VTE. Taken from UK VERITY (Venous Thromboembolism registry).
3. Figure 1.3 Rates of different cancers in the non‐VTE and VTE population; odds ratios for different types of cancer. Taken from UK VERITY (Venous Thromboembolism registry).
4. Figure 1.4 Risk assessment for VTE in cancer patients.
Chapter 05
1. Figure 5.1 Diagnostic algorithm for deep vein thrombosis. DVT – deep vein thrombosis; HS – high sensitivity; US – ultrasonography.
2. Figure 5.2 Diagnostic algorithm for pulmonary embolism. HS – high sensitivity; PA – pulmonary angiography; PE – pulmonary embolism; US – ultrasonography; V/Q scan – pulmonary ventilation/perfusion scan.
3. Figure 5.3 Generation of fibrin/fibrinogen degradation products (FDPs) and D‐dimer.
4. Figure 5.4 Diagnostic algorithm for recurrent deep vein thrombosis. DVT – deep vein thrombosis; HS – high sensitivity; US – ultrasonography.
5. Figure 5.5 Mechanism of action of the leading anticoagulant drugs. F – factor; LMWH – low molecular weight heparin; VKAs – vitamin K antagonists.
6. Figure 5.6 Laboratory assessment of the leading anticoagulant drugs. APTT – activated partial thromboplastin time; dRVVT – dilute Russell viper venom time; dTT – dilute thrombin time; ECT – ecarin clotting time; FXa – activated factor X; LC‐MS/MS – liquid chromatography tandem mass spectrometry; LMWH – low molecular weight heparin; PT – prothrombin time; UFH – unfractionated heparin; VKAs – vitamin K antagonists.
Chapter 07
1. Figure 7.1 Flowchart in patients with suspected PE, classified as high‐risk patients (modified from Konstantinides et al., 2014). CTPA – computed tomography pulmonary angiography; RV – right ventricle; PE – pulmonary embolism.
2. Figure 7.2 Flowchart in patients with suspected PE, classified as non‐high‐risk patients (modified from Konstantinides et al., 2014). CTPA – computed tomography pulmonary angiography; PE – pulmonary embolism.
Chapter 09
1. Figure 9.1 Algorithm for managing DVT as an outpatient.
2. Figure 9.2 An algorithm to guide the decision for managing PE as an outpatient.
Chapter 10
1. Figure 10.1 Counselling form used by GCAS when commencing patient on Vitamin K antagonist.
2. Figure 10.2 GCAS risk assessment form for patients requiring domiciliary visits for INR testing.
3. Figure 10.3 GCAS protocol outlining patient and GCAS responsibilities, and signed agreement form for INR self‐testing.
Chapter 11
1. Figure 11.1 Calibration of a new reagent using reference thromboplastin.
2. Figure 11.2 Comparison of three INR tests performed on the same patient on the same day: (a) shows results which are accurate and precise; (b) shows results that are inaccurate but precise; (c) shows inaccurate and imprecise results.
Chapter 13
1. Figure 13.1 Initial venogram via a popliteal vein catheter, demonstrating acute thrombus in the femoral vein with increased flow through deep perforator branches, and the greater saphenous vein (GSV).
2. Figure 13.2 Follow‐up venogram after 12‐hour CDT rt‐PA infusion demonstrates minimal residual thrombus with preferential flow through the femoral vein and decreased flow through perforators. The GSV is no longer visualised.
3. Figure 13.3 Venogram through popliteal catheter demonstrates acute thrombus in the popliteal and femoral vein.
4. Figure 13.4 Venogram after overnight CDT rt‐PA infusion demonstrates complete thrombus resolution.
5. Figure 13.5 Pelvic venogram through right femoral catheter demonstrates acute on chronic thrombus extending to the IVC filter. Contrast surrounds the acute thrombus in the IVC and right iliac veins.
6. Figure 13.6 Left pelvic venogram through left common femoral vein catheter, collateral veins due to acute on chronic thrombus of the left iliac system.
7. Figure 13.7 Overnight, CDT dissolved acute thrombus. However, there was residual high grade thrombus so, therefore, stenting of the iliac veins and IVC was performed. The final angiogram demonstrates anatomic flow without stenosis.
Chapter 15
1. Figure 15.1 Virchow’s triad in pregnancy.
2. Figure 15.2 Obstetric thromboprophylaxis risk assessment and management.
3. Figure 15.3 Common and important causes of chest pain and breathlessness in pregnancy.
4. Figure 15.4 Investigation algorithm for DVT in pregnancy.
5. Figure 15.5 RCOG diagnostic algorithm for PE in pregnancy.
Chapter 16
1. Figure 16.1 Virchow’s triad explains the pathophysiology underlying the majority of thrombosis in children.
Chapter 17
1. Figure 17.1 Risk factors for cancer‐associated thrombosis.
Chapter 18
1. Figure 18.1 Relationship between lean body weight (LBW) and drug clearance, as stipulated by Han et al. (2007). Patients to the right of the vertical dashed line are obese (>30 kg/m²). The linear relationship between clearance and LBW is shown by the LBW (solid curve) and clearance graphs (dotted curve) running parallel to each other.
Chapter 22
1. Figure 22.1 (a) Suggested diagnostic algorithm for suspected upper extremity DVT.
Chapter 23
1. Figure 23.1 Suggested anticoagulant therapies for the acute‐phase SVT in different situations.
Chapter 26
1. Figure 26.1 Suggested algorithm for stepwise approach in evaluation, diagnosis and management of CTEPH.
2. Figure 26.2 (a) Proximal vessel narrowing in right upper lobe (solid white arrow) and on lateral view, intimal irregularities anterior right lower lobe vessel (open white arrow). (b) Segmental level narrowing left upper lobe arteries (open black arrow), with what appears to be ‘web’ narrowing of proximal left descending PA. That on lateral view was the lingula artery (solid black arrow); the left descending PA was completely occluded beyond the lingula. These angiographic findings are consistent with organized thromboembolic disease.
3. Figure 26.3 Suggested algorithm for treatment approaches for patients with CTEPH.
Chapter 27
1. Figure 27.1 Conceptual framework for risk of recurrent VTE following provoked and unprovoked first VTE.
2. Figure 27.2 Cumulative rates of VTE recurrence‐free survival according to DASH score.
Chapter 31
1. Figure 31.1 VTE risk assessment tool for medical and surgical inpatients (excluding orthopaedics, obstetrics and gynaecology)
2. Figure 31.2 VTE risk assessment for obstetric patients, using a points system.
3. Figure 31.3 Proposed risk assessment and preventative measures in travellers.
Chapter 32
1. Figure 32.1 Aims of National VTE Exemplar Centres in England.
2. Figure 32.2 Essential criteria for VTE Exemplar Centres.
3. Figure 32.3 e‐learning modules available in England.
Chapter 33
1. Figure 33.1 An effective path to follow when planning an RCA.
2. Figure 33.2 Team structure.

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Library of Congress Cataloging‐in‐Publication Data

Names: Thachil, Jecko, editor. | Bagot, Catherine, editor.
Title: Handbook of venous thromboembolism / edited by Jecko Thachil and Catherine Bagot.
Description: Chichester, West Sussex ; Hoboken : John Wiley & Sons, 2018. | Includes bibliographical references and index. |
Identifiers: LCCN 2017039383 (print) | LCCN 2017040998 (ebook) | ISBN 9781119095590 (pdf) | ISBN 9781119095583 (epub) | ISBN 9781119095576 (cloth)
Subjects: | MESH: Venous Thromboembolism
Classification: LCC RC697 (ebook) | LCC RC697 (print) | NLM WG 610 | DDC 616.1/45–dc23
LC record available at https://lccn.loc.gov/2017039383

Cover Design: Wiley
Cover Image: ©London_England/iStockphoto

List of Contributors

William R. Auger, MD
University of California, San Diego, USA

Catherine Bagot, BSc, MBBS, MD, MRCP, FRCPath
Consultant Haematologist, Department of Haematology, Glasgow Royal Infirmary, Glasgow, UK

Rebecca Barton, MBBS, BBioMedSc
Department of Clinical Haematology, Royal Children’s Hospital, Melbourne, Australia

Enrico Bernardi, MD, PhD
Department of Emergency and Accident Medicine, Hospital of Conegliano, Italy

Karen Breen, MD, MRCPI, FRCPath
Dept of Thrombosis, St.Thomas’ Hospital, London

Andrew Busuttil, MD, MRCS
Academic Section of Vascular Surgery, Charing Cross Hospital, Imperial College London, UK

Giuseppe Camporese, MD
Unit of Angiology, Department of Cardiac‐Thoracic‐Vascular Sciences, University Hospital of Padua, Italy

Lana A. Castellucci, MD, MSc
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada

Yen‐Lin Chee, MBChB, MRCP, PhD, MRCPath
Consultant Haematologist, Department of Hematology‐Oncology, National University Cancer Institute, Singapore

Marco Das, MD, PhD, MBA
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands

Alun H. Davies, MA, DM, DSc, FRCS, FHEA, FEBVS, FACPh
Academic Section of Vascular Surgery, Charing Cross Hospital, Imperial College London, UK

Kerstin de Wit, MBChB, BSc, MSc, MD
Department of Medicine, McMaster University, Hamilton, Ontario, Canada

C.E.A. Dronkers, MD
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands

Emmanuel J. Favaloro, BSc (Hons), MAIMS, PhD, FFSc (RCPA)
Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Pathology West, NSW Health Pathology, Westmead Hospital, Westmead, NSW, Australia

David Fitzmaurice, MBChB, MRCGP, MD, FRCGP
Professor of Cardiorespiratory Primary Care, University of Warwick, Coventry, UK

Lauren Floyd, MBBS, MRCP
Core Trainee, Manchester Royal Infirmary, Manchester, UK

Massimo Franchini, MD
Department of Hematology and Transfusion Medicine, C. Poma Hospital, Mantova, Italy

Emma Gee, BSc
Nurse Consultant, Thrombosis and Anticoagulation, King's College Hospital NHS Foundation Trust, London, UK

Francesca Gianniello, MD
A. Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda ‐ Ospedale Maggiore Policlinico, Milan, Italy

Carlos J. Guevara, MD
Interventional Radiology Section, Mallinckrodt Institute of Radiology, Washington University in St. Louis, USA

Paul Hahn, MD, PhD
Department of Ophthalmology, Duke University Medical Center, Durham

Dan Horner, BA, MBBS, MD, PgCert, MRCP (UK) FCEM FFICM
Consultant in Emergency Medicine and Intensive Care, Salford Royal NHS Foundation Trust, Manchester, UK

M.V. Huisman, MD
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands

Francesca Jones, MBBS, MRCP, FRCPath
Haematology consultant

Department of Haematology, University Hospital Coventry and Warwick, NHS Foundation Trust, UK

David Keeling, BSc MD FRCP FRCPath
Consultant Haematologist, Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals, Oxford, UK

Dianne Patricia Kitchen
Point of Care, UK NEQAS for Blood Coagulation, Sheffield, UK

F.A. Klok, MD, PhD
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands

Dawn Kyle, BSC, RGN
Team Leader, Glasgow and Clyde Anticoagulation Service, Glasgow, UK

Kathryn Lang, MBBS, MRCP(UK)
King’s Thrombosis Centre, Department of Haematological Medicine, King’s College Hospital Foundation NHS Trust, London

Will Lester, MBChB, BSc, FRCP, FRCPath, PhD
Haematology Consultant

Department of Haematology, University Hospital Birmingham NHS Foundation Trust

Giuseppe Lippi, MD
Section of Clinical Biochemistry, University of Verona, Verona, Italy

Molly W. Mandernach, MD, MPH, FACP
University of Florida College of Medicine, Gainesville, Florida, USA

Ida Martinelli, MD, PhD
A. Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda ‐ Ospedale Maggiore Policlinico, Milan, Italy

Paul Monagle, MBBS, MD, MSc, FRACP, FRCPA, FCCP
Department of Clinical Haematology & Department of Paediatrics, University of Melbourne Royal Children’s Hospital, Victoria, Australia

Kathy Macintosh, BSc
Team Leader, Glasgow and Clyde Anticoagulation Service, Glasgow, UK

Alison Moughton
Anticoagulant Nurse Specialist

Department of Haematology, University Hospital Birmingham NHS Foundation Trust

Simon Noble, MBBS, MD, FRCP
Division of Population Medicine, Cardiff University, Cardiff, Wales

Serena M. Passamonti, MD, PhD
A. Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda ‐ Ospedale Maggiore Policlinico, Milan, Italy

Jignesh Patel, BSc(Hons), MSc, PhD
Institute of Pharmaceutical Science, Faculty of Life Sciences and Medicine, King’s College, London & King’s Thrombosis Centre, Department of Haematological Medicine, King’s College Hospital Foundation NHS Trust, London, UK

Demosthenes G. Papamatheakis, MD
University of California, San Diego, USA

Catherine Nelson Piercy, PhD, FRCP, FRCOG
Professor of Obstetric Medicine, Women’s Health Academic Centre, Guy’s and St Thomas’ Foundation Trust, London, UK

Anita Rajasekhar, MD, MS
University of Florida College of Medicine, Gainesville, Florida, USA

Gill Parmilan, MBBS, MRCP
Core Trainee, Manchester Royal Infirmary, Manchester, UK

Peter E. Rose, BSc(Hons), PhD
Consultant Haematologist, Warwick Hospital, South Warwickshire Foundation Trust, UK

Linda Smith, RGN/BSC
Team Leader, Glasgow and Clyde Anticoagulation Service, Glasgow, UK

Scott M. Stevens, MD
Department of Medicine, Intermountain Medical Center, Murray, Utah, and Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA

R. Campbell Tait, MBChB, FRCPSG, FRCPath
Honorary Professor of Haemostasis and Thrombosis, Department of Haematology, Glasgow Royal Infirmary, Glasgow, UK

Jecko Thachil, MBBS, MD, MRCP, FRCPath
Department of Haematology, Manchester Royal Infirmary, Manchester, UK

Suresh Vedantham, MD
Interventional Radiology Section, Mallinckrodt Institute of Radiology, Washington University in St. Louis, USA

Henry G. Watson, MD, FRCP, FRCPath
Consultant Haematologist and Honorary Professor of Medicine, Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, Scotland, UK

Christian Weimar, MD
Department of Neurology and Stroke Center, University Duisburg‐Essen, Germany

Joachim E. Wildberger, MD, PhD
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands

Scott C. Woller, MD
Department of Medicine, Intermountain Medical Center, Murray, Utah, and Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA

Wenlan Zhang, MD
Department of Ophthalmology, Duke University Medical Center, Durham

Handbook of Venous Thromboembolism

List of Contributors

Foreword

Section I
Clinical Overview